Usefulness of Apolipoprotein B/Apolipoprotein A-I Ratio to Predict Coronary Artery Disease Independent of the Metabolic Syndrome in African Americans

Abstract

Studies demonstrate that the apolipoprotein B/apolipoprotein A-I (ApoB/apoA-I) ratio predicts cardiovascular risk better than any of the cholesterol indexes. A number of factors that define the metabolic syndrome (MS) differ across African-American and European-American ethnicities. We assessed relationship of the apoB/apoA-I ratio to MS and coronary artery disease (CAD) in 224 African-Americans and 304 European-Americans. The MS was defined by the revised NCEP-ATP III criteria and CAD was assessed as ≥50% stenosis or a continuous cardiovascular score (0–75). European-Americans had higher apoB/apoA-I ratio compared with African-Americans (1.15 vs. 1.07, P=0.008). The apoB/apoA-I ratio was associated with presence of the MS in both European-Americans (OR=5.9; 95% confidence interval (CI), 2.53–13.57; P<0.001) and African-Americans (OR=8.3; 95% CI, 3.52–19.25; P<0.001), and was higher in subjects with MS compared to those without MS (1.21 vs. 1.04, P<0.001 for European-Americans and 1.20 vs. 0.94, P<0.001 for African-Americans). There was a stepwise increase in the prevalence of MS across apoB/apoA-I ratio tertiles in both ethnic groups (χ2=13.1, P<0.001 for European-Americans and χ2=19.6, P<0.001 for African-Americans). In multiple regression analyses, the apoB/apoA-I ratio independently predicted CAD in African-Americans (β=0.242, P=0.011). The cardiovascular score was significantly increased across apoB/apoA-I ratio tertiles in European-American subjects with MS (P=0.001), whereas this association was seen in African-American subjects without MS (P=0.023). In conclusion, the apoB/apoA-I ratio differed across ethnicities and was associated with presence of the MS in both groups. Among African-Americans, elevated apoB/apoA-I ratio independently predicted higher risk for CAD.

Association of Apolipoprotein B/Apolipoprotein A1 Ratio and Coronary Artery Stenosis and Plaques Detected by Multi-Detector Computed Tomography in Healthy Population

“…Moreover, this ratio has been shown to be a better indicator than any other lipid measurements, including conventional lipid ratios, of the presence and/or severity of coronary artery disease detected by conventional coronary angiography (16-18). However, despite the close relationship between serum apoB/A1 ratio and CHD detected by conventional coronary angiography, no previous study attempted to determine the optimal apoB/A1 cut-off value for identifying the subjects with significant coronary stenosis, especially using coronary MDCT.…”

Association of apolipoprotein B and incidence of metabolic syndrome in Korean men: A 5-years' follow-up study

“…Researchers found that elevated serum ApoB levels were associated with cardiovascular disease [6,7], coronary artery disease [8,9], diabetic retinopathy [10] and diabetes mellitus [11]. In addition, a recent cross-sectional study have been conducted that serum ApoB levels are positively associated with the prevalence of MetS in Asian population [12].…”

The value of apolipoprotein B/A1 ratio in the diagnosis of metabolic syndrome in a Korean population

“…Several studies have suggested that the apoB/A1 ratio could be a better marker of cardiovascular risk 9,10,12,13 . In the background that both MetS and apoB/A1 ratio are risk factors for future CVD, there have been several studies that investigated the association between MetS and apoB/A1 ratio, and most have reported a close relationship 14–20 . However, despite the close relationship between apoB/A1 ratio and MetS, few data are available about the association between apoB/A1 ratio and MetS, and furthermore, the optimal cut‐off value of apoB/A1 ratio for detecting subjects with MetS has remained undetermined in Asian populations.…”